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Home My WebLink AboutPermit Building 1993-02-18RESIDENTIAL PERMIT APPLICATION lnspections:726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: ASSESSOFIS MAP SPFrIN FIELD ? 70/93 Zfr, JOB NUMBER 225 Fifth Street Spri ng field, Oregon 97 477 Z J TAX LOT: SUBDIVISION qvHAr.J ou il o.i A tl tL Dt Yr t.1G":Y X1 GLI-_r-f STATE:ztP PHONE:1 ).b-OWNER: ADDRESS CITY: W ADDITION DEMOLISH OTHER DESCRIBE WORK: NEW - REMoDEL}(- ELECTRICAL, t t ADDRESS EXPI RES PHONE l/ t1 CONTRACTOR'S NAME MECHANICAL: CONST. CONTRACTOR # G EN ERAL: PLUMBING RANGE: g OF BDRMS: _ OFFICE USE _ WATER HEATEB: ZONING CODE: FLOOD PLAINOUAD AREA: g OF BLDGS: SECONDARY HEAT: SOUARE FOOTAGE: CONSTFI. TYPE HEAT SOURCE: LAND USE: # OF UNITS OCCY GROUP: '{ OF STORIES To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS [-l Temporary Electric x I Sile lnspection - To be made af ter excavation, but prior to setting forms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Fooling - After trenches are excavated. Masonry - Steel location, bond beams, grouting. Foundation - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. Underlloor Plumbing / Mechanical - Prior to insulation or decking. Post and Beam - Prior to floor insulation or decking. Floor lnsulation - Prior to decki ng. Sanitary Sewer - Prior to f illing trench. Slorm Sewer - Prior to filling trench." Water Line - Prior to filling trench. EZ Rough Electrical - Prior to/*over. Rough Mechanical - Prior to cover. Eleclrical Service - Must be approvec, to obtain permanent electrical power. Fireplace - Prior to facing materials and f raming lnsp. Wood Slove - After installation lnsert - After fireplace approval and installation of unit. Curbcul & Approach - After forms are erected but prior to placement of concrete. Sidewalk & Driveway - After excavation is complete, lorms and sub-base materia! in place. l-_l Fence - When cornpleted Streel Trees - When all required trees are planted. Final Plumbing - When all plumbing work is complete. Final Electrical - Whea all electrical work is complete. Final Mechanical - When all mechanical work is complete. E .x. ,X., K XI Framing - Prior to cover. p[ WattlCeiling lnsulation - Prior toA{ cover. flo'r*ull - Prior to taPing' Final Building - When ail required inspections have been approved and building is completed. Other MOBILE HOME INSPECTIONS Blocking and Set.Up - When all blocking is complete. Plumbing Connections - When home has been connected to water and sewer. Eleclrical Conneclion - When blocking, set-up, and plumbing inspections have been approved and the home is connected tothe service panel. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. fiJ nough Plumbing - Prior to )Acover. LOT: - BLOCK: ll E E E r tl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Tyf)e - Inter'ior -- Corner - Panhancllc -.- Cul-tie-sac Sc t b;rc k:: P.L.HSE cAit ACC -- HE PROPOSED WCHK lN r r,- , .TORICAL DISTRICT, OR ON THE HISTORICAL FIEGISTER? _- if yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED ----l INi c E l BUILDING VALUE, PLAN CHECK AT{D BUILDING PERMIT Thrs permit is granted on the express condition that the said construction shali, in all respccts; confoi"'n to the Ordinance adopted by the City of Springfielcj, includlng the Development Code, r'egulating the construction and use of br-rildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances' DatePlans Revicwed BY Plan Check Fee: Date Paid Hecei pt Number:--- Received By: Te*a{+h+ue- DUA/ Building Permit Fee State Surcharge Total Fee BUILDING PERMIT VALU F: ,rukt, (A) SO. FT. X $/SO. FT. lcao ITEM Main Garage Carport lsy _ ,75 T,7S Syslems Developnlent Charge is due on all undeveloDed properties within the City limits which are being improved'sYSr E M s D EV E Lo P * = * r,"1, ^vlfr:r"L# ADDITIONAL COMMENTS Fixt u res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home N0 (c) FT. FT. FT. 30.tu "-t:r9 b/,?_ PLUMBING PERMIT ITEM FEE ?P Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fi replace Unit Dryer Vent MECHANICAL PERMIT (D) Zltrt), t 75 N0 Mechanical Permit lssuance State Surcharge Total Permit /_549 t<, oo/ \J, / o?a Fu rnace Exhaust Hood Vent Fan By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information hereon is true and correct, and I f urther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division' I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this proiect. ! f urther agree to ensure that all require'J inspections are 'equesi:d .1 :ile ;)rcpei' iime, thct eauh ad'jress is readable fronr the street, that the permit card is located at the {ront rty, and the apprcved set of plans will remain ignature Date cf the prope orr the site at all rncs during constructi M ISCEi.LAi{ EOUS PERM ITS Mobile Home Siate lssuance State Surcharge Sidewalk __-- ft Curbcut '--. ft Demolition state surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D. and E Combined) VALIDATION RECEIPT NUMBE D,ATE PAiD AfvlOUl.lT RECE IVEt)3A FiECTIVED BY -- 15 # -BWQP 8w4 Permit No: Address: lssued by Date:2-/7'73 R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: 1. ,[X I own, reside in, or will reside in the completed structure. 2.4 I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3.4 My general contractor is , Contractor registration number- I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B.El will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. ! hereby certify that the above information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reYerse side ol this form. x "?ture o t CONSTRUCTION CONTRACTORS BOARD 0244J 8191 t te WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ?:o, e = INFORIIftATION NOTICE TO PROPERTY OVI/}tERS ABOUT CONSTRUCTION HESPONSIBILTTIES NOfE: This lnformation Notice to Property Owners About Construction Responsibilitbs was developed by the Construction Contractors Board in accordance with OFIS 701.0SS(S), pasSed by, the..1989 Oiergon Legislature ...: -1f'you ard'acting as your own conlractor to construct a new home or make a substantial improuement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be,ruled to be an "employer" and the people you hire will be "employees". As the employer, you must comply with the following: gregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Department of Flevenue at 378-S3g0. Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon EmploynpntDivision DHR a|378-3224. Workers' Compensarion lnsurance: As an employer, you are subject to the Oregon *"rn"6; rompensation pensationinsuranceforyouiemployees'ityoufailtoobtainworkerS, compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 573-2494. U.S. lnternal Revenue Service: As an employel you must withhold federal income tax from employees'wages. ymentevenifyoudidn'tactuallywithholdthetax'Formoreinformation,call the lnternal Revenue Service at 22'l-3960. OTHER RESPONSIBILITIES AND AHEAS OF CONGEHN: Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. LiabiliU and Property Damage lnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervise Employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. - "/" ' lf you have additional questions, write to Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 1A124189 L-.,n CITY OF SPRI {i-'ot no . ?eo t89 NGFIELD SYSTEI'IS DEVELOPMENT CHARGE WOHKSHEET (C0uMERCIAL & RESIDENTIAL) 51 UftNlo u t-.1 o u A t..\E f r-lo xc 3( NAME OR COMPANY: LOCATION:4tt - ADD MDEVELOPMENT TYPE:/-oe BUILDING SIZE:T SIZ I. STORM DRAINAGE IMPERVIOUS SQ. FT.x $0.192 PER SQ. FT. 2. SANITARY SEWER-CITY NO. OF PFU'S (See Reverse) ')X $39.78 PER PFU TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP s a. Ft 3 X X X x $401.05 x $401.05 x $401.05 suBToTAL (ADD ITEMS 1,2, & 3l s zlgag 4 ADMINISTRATIVE FEES BASE CHARGE (SUBToTAL AB0VE) X .05 5. SANITARY SEWER-Mt,lMC TOT -C ITY SDC $13.62 PER PFU + $10 MI,JMC ADMIN. FEE TOTAL-MWMC SDC s Z7u $-NO. OF PFU'S (Use PFU Total From Item 2 Above ) MhIMC CREDIT IF APPLICABLE (SEE REVERSE) K p Burdick SDC Coordinator L /-1 TOTA SDC sz1 N t1D x FIXTURE UNIT CALCUI-AT. JN TABLE: ttumoer of New Fixtures X U For remodels, calculate only theNfl additional fixtures) NUMBER OF FIXTURE TYPE NEW FITTURES Equivalent = Fixture Units (NOTE: UNIT FIXI-URE EQUIVALENT UNITS Bathtub....... Drinking Fountain...... Floor Drain. I nterceptors For Grease/Oil/Solids/Etc................ I nterceptors For Sand/Auto Wash/Etc.................. Laundry Clotheswasher - 3 Or More.-...............,q.-................ Mobile Home Park Trap (1 Per Trailer)........ Receptor For RefrigeratorAVater Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Sta|I............. Shower, Gang........... Sink, Bar, Commercial Urinal, StallflVall.... Wash Basin/Lavatory, Single. Water Closet, Public lnstallation. Water Closet, Private..... Miscellaneous: I /Head 2 1 2 3 6 2 6 6 1 3 2 1 2 2 1 o 4 1- --+- TOTAL FIXTURE UNITS I i CREDIT CALCUI-ATION TABLE: Based on assessed value. calculate credits separates. lf improvements occurred after annexation date in table, $Credit for Parcel or l-and Only lf Applicabte lmprovement (if after annexation date) x$ (Rate X Assessed Value)x$ (Rate X Assessed Value) CREDIT TOTAL = g Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value 1979 or before 1980 1981 1982 1983 1984 $2.83 2.76 2.71 2.60 2.46 2.33 1 985 1 986 1987 1988 1 989 1990 1991 $2.1 6 1.90 1.60 0.25 o.B7 0.50 0.16 RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential.. Commercial lndustrial..... Governmental. 0.4 0.9 0.45 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT onEG0t, ei! 225 FTFI'E STRBET SPRINGFTEU), oREGON 97477 INSPBCTION REOUBSTz 726-37 OFFICE: 726-3759 1. LOCATION OP INST Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if work is suspended for 180 days. 2. CO}.ITRACTOR INSTALI,ATION ONLY Electrical Contractor Address city- Phone Supervisor License Nilmber Expiration Date Constr Contr. Number Exoiration Date Signature of Supervising Blectrician 0wners Name Address Ds OIJNER INSTALI.ATION The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Ovners ignature: DATE: * ELBCTRICAL PBRHIT APPLICATION Ci ty Job Nunber COHPI^ETB T'BE SCTEDULE BBLOV Nev Residential-Single or HuIti-Family per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf 'd llome or Modular Dvelling Service or Feeder $ 8s.00 $ 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: ts-1 $ff2 A Sum B ctty c/ft vno"" 72L-??Ay' D. Branch Circuits Nev, Alteration or Extension Per Panel One Ci rcui t t--- S 35.00 35 rc Each Addi tional Circuit or vith Service or Feeder Permi t S 2.00 200 amps or less 201 amps to 400 "mps -401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect 0n1y Hiscellaneous (Service/feeder -Each installation Ptrmp or irrigation S Sign/0utIine Lighting_ $ Limi ted Energy/Res $ Limited Energy/Comm S SI'BTOTAL OP ABOVE 5Z State Surcharge TOTAL C. Temporary Services or Feeders InstaLlation, Alteration or Relocation $ s0.00 $ 60.00 $100.00 $130.00 s300.00 $ 40.00 2/7 200 amps or less $ 40.00 201 amps to 400 amps - $ 55.00 Over 401 to 600 amps - $ 80.00 Over 600 amps or L000 volts see "B[ above E not included) 40.00 40. oo 20. 00 'n5 Doua:V H4- 7?Tt5RECEIVED BY: 7/, @ JOB DESCRIPTION tz- C---'l-.r; (Z/,- A Zl